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Brihmat N, Bayram MB, Bheemreddy A, Saleh S, Yue GH, Forrest GF. Insights into COVID-19 pathophysiology from a longitudinal multisystem report during acute infection. Exp Neurol 2024; 380:114917. [PMID: 39127120 DOI: 10.1016/j.expneurol.2024.114917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 08/06/2024] [Accepted: 08/07/2024] [Indexed: 08/12/2024]
Abstract
The Coronavirus disease 2019 (COVID-19), an illness caused by a SARS-CoV-2 viral infection, has been associated with neurological and neuropsychiatric disorders, revealing its impact beyond the respiratory system. Most related research involved individuals with post-acute or persistent symptoms of COVID-19, also referred to as long COVID or Post-Acute Sequelae of COVID-19 (PASC). In this longitudinal unique report, we aimed to describe the acute supraspinal and corticospinal changes and functional alterations induced by a COVID-19 infection using neuroimaging, neurophysiological and clinical assessment of a participant during acute infection, as compared to three other visits where the participant had no COVID-19. The results favor a multisystem impairment, impacting cortical activity, functional connectivity, and corticospinal excitability, as well as motor and cardiovascular function. The report suggests pathophysiological alteration and impairment already present at the acute stage, that if resolved tend to lead to a full clinical recovery. Such results could be also insightful into PASC symptomatology.
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Affiliation(s)
- Nabila Brihmat
- Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation, West Orange, NJ, United States; Department of Physical Medicine and Rehabilitation, Rutgers - New Jersey Medical School, Newark, NJ, United States.
| | - Mehmed B Bayram
- Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation, West Orange, NJ, United States; Department of Physical Medicine and Rehabilitation, Rutgers - New Jersey Medical School, Newark, NJ, United States
| | - Akhil Bheemreddy
- Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation, West Orange, NJ, United States
| | - Soha Saleh
- Department of Rehabilitation and Movement Sciences, Rutgers School of Health Professions, Newark, NJ, United States; Department of Neurology, Robert Wood Johnson Medical School (RWJMS), New Brunswick, NJ, United States
| | - Guang H Yue
- Department of Physical Medicine and Rehabilitation, Rutgers - New Jersey Medical School, Newark, NJ, United States; Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
| | - Gail F Forrest
- Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation, West Orange, NJ, United States; Department of Physical Medicine and Rehabilitation, Rutgers - New Jersey Medical School, Newark, NJ, United States; Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States.
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Kausel L, Figueroa-Vargas A, Zamorano F, Stecher X, Aspé-Sánchez M, Carvajal-Paredes P, Márquez-Rodríguez V, Martínez-Molina MP, Román C, Soto-Fernández P, Valdebenito-Oyarzo G, Manterola C, Uribe-San-Martín R, Silva C, Henríquez-Ch R, Aboitiz F, Polania R, Guevara P, Muñoz-Venturelli P, Soto-Icaza P, Billeke P. Patients recovering from COVID-19 who presented with anosmia during their acute episode have behavioral, functional, and structural brain alterations. Sci Rep 2024; 14:19049. [PMID: 39152190 PMCID: PMC11329703 DOI: 10.1038/s41598-024-69772-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 08/08/2024] [Indexed: 08/19/2024] Open
Abstract
Patients recovering from COVID-19 commonly exhibit cognitive and brain alterations, yet the specific neuropathological mechanisms and risk factors underlying these alterations remain elusive. Given the significant global incidence of COVID-19, identifying factors that can distinguish individuals at risk of developing brain alterations is crucial for prioritizing follow-up care. Here, we report findings from a sample of patients consisting of 73 adults with a mild to moderate SARS-CoV-2 infection without signs of respiratory failure and 27 with infections attributed to other agents and no history of COVID-19. The participants underwent cognitive screening, a decision-making task, and MRI evaluations. We assessed for the presence of anosmia and the requirement for hospitalization. Groups did not differ in age or cognitive performance. Patients who presented with anosmia exhibited more impulsive alternative changes after a shift in probabilities (r = - 0.26, p = 0.001), while patients who required hospitalization showed more perseverative choices (r = 0.25, p = 0.003). Anosmia correlated with brain measures, including decreased functional activity during the decision-making task, thinning of cortical thickness in parietal regions, and loss of white matter integrity. Hence, anosmia could be a factor to be considered when identifying at-risk populations for follow-up.
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Affiliation(s)
- Leonie Kausel
- Laboratorio de Neurociencia Social y Neuromodulación (neuroCICS), Centro de Investigación en Complejidad Social (CICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile
- Centro de Estudios en Neurociencia Humana y Neuropsicología (CENHN), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | - Alejandra Figueroa-Vargas
- Laboratorio de Neurociencia Social y Neuromodulación (neuroCICS), Centro de Investigación en Complejidad Social (CICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile
- Laboratorio LaNCE, Centro Interdisciplinario de Neurociencia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Zamorano
- Unidad de Imágenes Cuantitativas Avanzadas, Departamento de Imágenes, Clínica Alemana de Santiago, Facultad de Medicina CAS-UDD, Universidad del Desarrollo, Santiago, Chile
- Facultad de Ciencias Para El Cuidado de La Salud, Universidad San Sebastián, Santiago, Chile
| | - Ximena Stecher
- Unidad de Imágenes Cuantitativas Avanzadas, Departamento de Imágenes, Clínica Alemana de Santiago, Facultad de Medicina CAS-UDD, Universidad del Desarrollo, Santiago, Chile
- Departamento de Imágenes, Clínica Alemana de Santiago, Clínica Alemana de Santiago, Facultad de Medicina CAS-UDD, Universidad del Desarrollo, Santiago, Chile
| | - Mauricio Aspé-Sánchez
- Laboratorio de Neurogenética, Centro Interdisciplinario de Neurociencias de Valparaíso (CINV), Universidad de Valparaíso, Valparaiso, Chile
| | - Patricio Carvajal-Paredes
- Laboratorio de Neurociencia Social y Neuromodulación (neuroCICS), Centro de Investigación en Complejidad Social (CICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile
| | - Victor Márquez-Rodríguez
- Laboratorio de Neurociencia Social y Neuromodulación (neuroCICS), Centro de Investigación en Complejidad Social (CICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile
| | - María Paz Martínez-Molina
- Laboratorio de Neurociencia Social y Neuromodulación (neuroCICS), Centro de Investigación en Complejidad Social (CICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile
| | - Claudio Román
- Centro de I&D en Ingeniería en Salud, Universidad de Valparaíso, Valparaíso, Chile
| | - Patricio Soto-Fernández
- Laboratorio de Neurociencia Social y Neuromodulación (neuroCICS), Centro de Investigación en Complejidad Social (CICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile
- Laboratorio de Neurogenética, Centro Interdisciplinario de Neurociencias de Valparaíso (CINV), Universidad de Valparaíso, Valparaiso, Chile
- Departamento de Evaluación de Tecnologías Sanitarias y Salud Basada en Evidencia, División de Planificación Sanitaria, Subsecretaría de Salud Pública, Ministerio de Salud, Santiago, Chile
| | - Gabriela Valdebenito-Oyarzo
- Laboratorio de Neurociencia Social y Neuromodulación (neuroCICS), Centro de Investigación en Complejidad Social (CICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile
| | - Carla Manterola
- Departamento de Pediatría, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile
| | - Reinaldo Uribe-San-Martín
- Departamento de Neurología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Servicio de Neurología, Hospital Dr. Sótero del Río, Santiago, Chile
| | - Claudio Silva
- Unidad de Imágenes Cuantitativas Avanzadas, Departamento de Imágenes, Clínica Alemana de Santiago, Facultad de Medicina CAS-UDD, Universidad del Desarrollo, Santiago, Chile
- Departamento de Imágenes, Clínica Alemana de Santiago, Clínica Alemana de Santiago, Facultad de Medicina CAS-UDD, Universidad del Desarrollo, Santiago, Chile
| | - Rodrigo Henríquez-Ch
- Laboratorio LaNCE, Centro Interdisciplinario de Neurociencia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Neurología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Aboitiz
- Laboratorio LaNCE, Centro Interdisciplinario de Neurociencia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Psiquiatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rafael Polania
- Decision Neuroscience Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Pamela Guevara
- Facultad de Ingeniería, Universidad de Concepción, Santiago, Chile
| | - Paula Muñoz-Venturelli
- Centro de Estudios Clínicos, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Patricia Soto-Icaza
- Laboratorio de Neurociencia Social y Neuromodulación (neuroCICS), Centro de Investigación en Complejidad Social (CICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile.
| | - Pablo Billeke
- Laboratorio de Neurociencia Social y Neuromodulación (neuroCICS), Centro de Investigación en Complejidad Social (CICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile.
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Simonini L, Frijia F, Ait Ali L, Foffa I, Vecoli C, De Gori C, De Cori S, Baroni M, Aquaro GD, Maremmani C, Lombardo F. A Comprehensive Review of COVID-19-Related Olfactory Deficiency: Unraveling Associations with Neurocognitive Disorders and Magnetic Resonance Imaging Findings. Diagnostics (Basel) 2024; 14:359. [PMID: 38396398 PMCID: PMC10888385 DOI: 10.3390/diagnostics14040359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Olfactory dysfunction (OD) is one of the most common symptoms in COVID-19 patients and can impact patients' lives significantly. The aim of this review was to investigate the multifaceted impact of COVID-19 on the olfactory system and to provide an overview of magnetic resonance (MRI) findings and neurocognitive disorders in patients with COVID-19-related OD. Extensive searches were conducted across PubMed, Scopus, and Google Scholar until 5 December 2023. The included articles were 12 observational studies and 1 case report that assess structural changes in olfactory structures, highlighted through MRI, and 10 studies correlating the loss of smell with neurocognitive disorders or mood disorders in COVID-19 patients. MRI findings consistently indicate volumetric abnormalities, altered signal intensity of olfactory bulbs (OBs), and anomalies in the olfactory cortex among COVID-19 patients with persistent OD. The correlation between OD and neurocognitive deficits reveals associations with cognitive impairment, memory deficits, and persistent depressive symptoms. Treatment approaches, including olfactory training and pharmacological interventions, are discussed, emphasizing the need for sustained therapeutic interventions. This review points out several limitations in the current literature while exploring the intricate effects of COVID-19 on OD and its connection to cognitive deficits and mood disorders. The lack of objective olfactory measurements in some studies and potential validity issues in self-reports emphasize the need for cautious interpretation. Our research highlights the critical need for extensive studies with larger samples, proper controls, and objective measurements to deepen our understanding of COVID-19's long-term effects on neurological and olfactory dysfunctions.
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Affiliation(s)
- Ludovica Simonini
- Institute of Clinical Physiology, National Research Council (CNR), 54100 Massa, Italy; (I.F.); (C.V.)
| | - Francesca Frijia
- Bioengineering Unit, Fondazione Toscana G. Monasterio, 56124 Pisa, Italy;
| | - Lamia Ait Ali
- Institute of Clinical Physiology, National Research Council (CNR), 54100 Massa, Italy; (I.F.); (C.V.)
- Pediatric Cardiology and GUCH Unit, Fondazione “G. Monasterio” CNR-Regione Toscana, 54100 Massa, Italy
| | - Ilenia Foffa
- Institute of Clinical Physiology, National Research Council (CNR), 54100 Massa, Italy; (I.F.); (C.V.)
| | - Cecilia Vecoli
- Institute of Clinical Physiology, National Research Council (CNR), 54100 Massa, Italy; (I.F.); (C.V.)
| | - Carmelo De Gori
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy; (C.D.G.); (S.D.C.); (F.L.)
| | - Sara De Cori
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy; (C.D.G.); (S.D.C.); (F.L.)
| | - Monica Baroni
- Fondazione “G. Monasterio” CNR-Regione Toscana, 54100 Massa, Italy;
| | - Giovanni Donato Aquaro
- Academic Radiology Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56124 Pisa, Italy;
| | - Carlo Maremmani
- Unit of Neurology, Ospedale Apuane, Azienda USL Toscana Nord Ovest, 54100 Massa, Italy;
| | - Francesco Lombardo
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy; (C.D.G.); (S.D.C.); (F.L.)
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